By registering to Neurology ECHO Network once you are automatically enrolled to all sessions.

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* 1. First name

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* 2. Last name

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* 3. Email address

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* 4. Mobile number

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* 5. What is your profession?

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* 6. Workplace name

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* 7. Workplace suburb

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* 8. Is your work location classified as:

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* 9. Would your work environment be described as

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* 10. Do you have a patient case you would like to discuss at the network?

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* 11. What would you like to gain from joining the Neurology ECHO Network?

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* 12. For each of the curriculum topics listed below, please share your learning needs and requests for specific focus areas:

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* 13. How did you hear about the Neurology ECHO Network?

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* 14. If you are a RACGP member and would like to claim 40 points for participating in this Peer Group Learning Accredited Activity (Reviewing Performance Category 1), please provide us with your RACGP membership number.

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* 15. If you are an ACRRM member and would like to claim points for participating in this Case Discussion Activity (Performance Review Category), please provide us with your ACRRM membership number.

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